Primary adenocarcinoid tumor of the ovary arising in mature cystic teratoma. A case report.

摘要

Primary carcinoid tumors of the ovary are rare, forming 0.3 % of all carcinoid tumors and less than 0.1 % of ovarian malignancies. We present a case of a 47-year-old woman with abnormal vaginal bleeding and abdominal discomfort. Pelvic ultrasonography revealed a right-sided, 4 cm solid ovarian mass. At laparoscopy, a smooth surfaced, firm and mobile right adnexal mass with solid and cystic portions was detected and the tumor was excised. Pathologic and immunohistochemical examination revealed carcinoid tumor. After the evaluation of gastrointestinal and respiratory systems by imaging and endoscopic studies, no evidence of tumor tissue or metastases were found. Based on this finding, total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and appendectomy were performed and pelvic-paraaortic lymph nodes were also removed. All histological findings were similar to the features of mature cystic teratoma and carcinoid tumor. Examination of the resected lymphatic, omental and appendicealtissue indicated no tumoral invasion. Thus, the diagnosis was primary ovarian carcinoid arising from a mature cystic teratoma. This case, in the setting of a normal appendix and negative workup for an extraovarian origin, is one of a primary ovarian adenocarcinoid tumor. The primary carcinoid tumor should be differentiated from a metastatic carcinoid inside the ovary, which is always bilateral. It is important to be aware of this unusual entity in diagnoses of ovarian tumors, even in the absence of any clinical symptoms of carcinoid syndrome.